The Shift to Consumer Driven Healthcare

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The future of patient engagement

The healthcare industry is approaching an exciting paradigm shift in patient engagement as we move away from being a mostly provider controlled industry to a consumer driven one.1 Much like the financial, music, and publishing industries in the past, healthcare is becoming a mobile, consumer-driven industry. In this consumer driven model, end-users (i.e. patients) drive healthcare industry spending and can receive and transmit health-related data in real-time. The main causes for this shift are the Affordable Care Act (ACA) and changing health insurance coverage. These changes have allowed for greater access to, and demand for, health information via smartphones and patient portals. The use of mobile medical devices and technology also empowers patients to take on and share responsibility for recording and transmitting their own health-related data.

Under the Affordable Care Act, health insurance exchanges now give patients the option to shop and compare plans in order to determine which has the best value for their individual needs. Being able to compare plan metrics such as premiums, copays, and direct payments side-by-side creates greater cost transparency than ever before in healthcare.1 This cost transparency and the ability to ultimately determine which coverage is right for them gives patients the power to become active healthcare consumers, rather than passive participants in the current system. As healthcare consumers, they expect to have the best quality of care and value the customer experience above all else. Under this new model, patients are empowered to closely monitor their healthcare spending and their own health, interact with the healthcare system outside the hospital walls, and employ the use of technology to improve their conditions.

To combat rising healthcare expenditures, many employers are shifting the costs of healthcare to their employees, offering high-deductible plans, rather than benefit-derived plans. Many of these plans have Health Savings Accounts (HSAs) that individuals use to directly fund numerous medical expenditures, eliminating health plans as the sole payer for health services. The Kaiser Family Foundation conducted its yearly Employer Health Benefits survey in 2013 and found that 23 percent of companies that provide health coverage to employees offer a high-deductible health insurance plan, and among those companies, 17 percent offer HSA-qualified plans and six percent offer coverage with a health reimbursement account.2

Using these high-deductible plans and HSAs has caused patients to become more cost-conscious when it comes to the care they receive. Thinking about how their health will affect their financial status, they want to find ways to cut costs and prevent expensive medical conditions -this also holds true for payers, the government, and providers who wish to be successful in this new, demand-based healthcare model. Medical devices and mobile technology continue to gain prominence in the healthcare industry because they can help meet this goal of reducing medical spending.

According to the Mobile Health 2012 Report from the Pew Internet & American Life Project, 45 percent of American adults own a smartphone. The Report found that among smartphone owners, 53 percent used their phones to access health information.3 Patients are no longer content to wait until their next appointment for health-related information or to access their own medical records. They want information in real-time -and they want the ability to upload data as well.

Mobile devices place the power to record and upload clinical data into the hands of patients, rather than exclusively with providers. Instead of visiting their physician for a simple test like a blood pressure or weight check, a device controlled by the patient can record these measurements and transmit the data to their physician through the digital cloud. This helps providers continue monitoring patients’ conditions after they are discharged and prevent adverse events that could send them back to the hospital. Preventing hospital stays and readmissions through mobile device use has the power to lower healthcare costs and improve overall population health. Mobile health can also empower patients to prevent or reduce their chances of contracting some of the most prevalent-and often preventable-diseases, such as type-two diabetes. Through mobile applications, patients are provided with the tools to meet their wellness goals and keep track of health-related behaviors. Studies have shown that patients who track their own health are empowered to make better choices,3 and according to Pew , 19 percent of U.S. smartphone users have at least one health application downloaded on their phones.4

In addition to mobile devices, patient engagement and customer satisfaction are key drivers of many quality measures programs that have been put into place over the last few years including Meaningful Use, PQRS and HEDIS. Becoming a consumer driven industry supports these quality measures, and encourages improved care coordination, which can ultimately lead to a better customer experience and high satisfaction survey ratings, as well as reduce errors and cost, and improve overall outcomes.

References

  1. Spoerl, Bob. Six Trends in an Era of Consumer-Driven Healthcare. Becker’s Hospital Review. June 6, 2012. Available at: http://www.beckershospitalreview.com/strategic-planning/6-trends-in-an-era-of-consumer-driven-healthcare.html\ Accessed December 20, 2013.
  2. The Kaiser Family Foundation and Health Research & Educational Trust. Employer Health Benefits 2013 Annual Survey. Available at: http://kaiserfamilyfoundation.files.wordpress.com/2013/08/8465-employer-health-benefits-20131.pdf. Accessibility verified December 20, 2013.
  3. The Pew Internet & American Life Project. Mobile Health 2012. Available at: http://www.pewinternet.org/Reports/2012/Mobile-Health.aspx Accessibility verified December 20, 2013.
  4. Comstock, Jonah. Fitbit study: UK adults find mobile health tracking, not public messaging, effective. Mobile Health News. Nov. 14, 2013. Available at: http://mobihealthnews.com/27382/fitbit-study-uk-adults-find-mobile-health-tracking-not-public-messaging-effective/ Accessibility verified December 20, 2013.
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About Author

Fauzia Khan, MD, FCAP

Chief medical officer and co-founder of Alere Analytics

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